Provider Demographics
NPI:1770657165
Name:SHARBAUGH'S DRUG STORE INC
Entity Type:Organization
Organization Name:SHARBAUGH'S DRUG STORE INC
Other - Org Name:SHARBAUGHS DRUG STORE INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER PHCST
Authorized Official - Prefix:
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHARBAUGH
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:814-344-9950
Mailing Address - Street 1:2073 PLANK ROAD
Mailing Address - Street 2:PO BOX 563
Mailing Address - City:CARROLLTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15722-0563
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2073 PLANK RD
Practice Address - Street 2:
Practice Address - City:CARROLLTOWN
Practice Address - State:PA
Practice Address - Zip Code:15722-6411
Practice Address - Country:US
Practice Address - Phone:814-344-9950
Practice Address - Fax:814-344-9952
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-20
Last Update Date:2024-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
PAPP411759L3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2079867OtherPK
PA0012095940002Medicaid
2079867OtherPK